The Massachusetts Mandate

On Tuesday Scott Brown made history by becoming the first Republican senator for Massachusetts in a generation. He may also make history as a roadblock in the path of the president's health-reform plan. Since bickering Democrats missed their own deadline to paper over their differences on health reform, Brown will soon take his seat in the Senate and thus could filibuster the unpopular White House proposal. In other words, ObamaCare just flat-lined.

Democratic pundits insist Brown's victory shouldn't be allowed to derail the legislation. But they're wrong. Brown has a clear mandate from Massachusetts voters to do exactly that--so clear that it makes President Obama's mandate for his own bill look weak in comparison.

Democratic legislators wasted 2009 writing a bloated health-reform bill with little reform. At every turn they added pork barrel spending, new bureaucracies and agencies and costly special deals to win over selected states. The last draft of the bill was over 2,000 pages long. Democrats wrote the plan with little respect for conservative concerns, assuming they'd have the votes to ram it through at their leisure.

Did Massachusetts know it would be voting to stop the president's bill? It wasn't like it was a secret. In a press conference in downtown Boston on Dec. 28, Brown told voters that if elected as the 41st senator in the anti-ObamaCare camp, he "could stop the Obama proposal that's being pushed right now through Congress." Massachusetts Democrats agreed. "If Scott Brown wins, it'll kill the health bill," Rep. Barney Frank said on Jan.15. Massachusetts voted for Brown anyway--or, more likely, because of it (ObamaCare negatives are high in the Bay State).

What makes Senator-elect Brown different is that his mandate isn't just a partisan protest. Brown has articulated his own pro-market views on health reform. In 2006 Gov. Mitt Romney brought universal health coverage to Massachusetts with a health insurance exchange, a legal requirement to buy insurance and subsidies for lower-income families. Brown supported those reforms as a state senator. But as a U.S. senate candidate, Brown also acknowledged RomneyCare's worst flaw: Politically motivated insurance regulations had driven health insurance prices far higher than the national average. ObamaCare, for the record, has plagiarized the worst of Massachusetts' reforms, setting the stage for a future in which everyone's insurance will be hyper-regulated.

Brown not only gets the problem, he's taken action. In a bold move mid-campaign he tabled legislation to roll back most insurance mandates. This exposed him to strong criticism. Right on cue his opponent claimed Brown was hurting patients and helping special interests.

In truth, insurance mandates benefit (medical) special interests at your expense. Suppose you're a 56-year-old single woman in Boston and you need affordable insurance. You definitely need coverage for osteoporosis, but you definitely don't need coverage for maternity costs. No luck: Thanks to Massachusetts law, you'll be forced to pay higher premiums for maternity coverage anyway. And your premiums must also cover you for hearing tests for newborns, testicular cancer, in vitro fertilization, participating in a clinical trial, substance abuse rehabilitation and (depending who's counting) between 31 and 47 other required services. It's one reason that after so much reform health insurance premiums in Massachusetts are nearly 50% higher than in the rest of the country.

In the campaign, Brown made his argument against insurance mandates clear. "Insurers should be free to put together policies that are tailored for the needs of their customers," he said. "If someone wants chiropractic care, they should purchase a policy that includes it, but no one should be required to buy it if they don't want or need it."

Imagine if politicians had been as direct as the senator-elect in their discussion of health issues throughout 2009. Massachusetts didn't need to imagine it: Voters there heard a moderate conservative speak his mind on how market insurance could work. They saw him make his intentions crystal clear. And one of the most liberal states in the Union rewarded him for it. It's the sort of clear mandate for change that President Obama would have praised--when he was a candidate. And since it's a mandate against ObamaCare, Democrats would be wise to respect it.

David Gratzer, a physician, is a senior fellow at the Manhattan Institute. He is the author of Why Obama's Government Takeover of Health Care Will Be a Disaster (Encounter Books, 2009).